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Ortho tests > Ankle > Flashcards

Ankle Flashcards

1
Q

What does Simmonds test

A

Achilles tear/rupture

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2
Q

Simmonds technique

A

Pt prone
Feet off couch
Squeeze calves

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3
Q

+ve Simmonds

A

No plantar flexion

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4
Q

What does talar tilt test

A

Inversion- lateral sprain (ant/post talofibular ligament, calcaneofibular lig, post talofibular lig)

Eversion- medial sprain (deltoid lig)

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5
Q

Talar tilt technique

A

Pt seated or supine
Place pillow under knee
Hand placement on lat + med malleoli
Invert foot & plantar flex is ant talofibular
Evert foot
Neutral calcanofibular
Full Doris flex post talofibular

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6
Q

+ve Talar tilt

A

Inversion- lateral sprain/rupture= P + increased motion

Eversion- med sprain= P + increased motion

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7
Q

Specificity of Talar tilt

A

75

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8
Q

Sensitivity of Talar tilt

A

67

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9
Q

What does ant/post drawer test

A

Ant talofibular ligament instability

Post ankle ligament instability

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10
Q

Ant/post drawer technique

A

Pt supine
Bend leg, foot on couch
Fix top of foot
Support round back of Achilles, pull forward post
Ant- push shin

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11
Q

+ve Ant/post drawer

A

Increased ant movement (ATFL)

Increased post movement (PTFL)

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12
Q

Ant/post drawer clinical notes

A

Compare bilaterally
In normal individuals test should produce little to no motion

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13
Q

What does Tinel’s sign test

A

Tarsal tunnel syndrome (post tibial nerve)

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14
Q

Tinels sign technique

A

Pt supine with hip of affected side ER + foot slightly everted
Tap behind medial malleolus- post tibial nerve/medial plantar nerve
Over the dorsum of the ankle near the neck of talus- deep peroneal

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15
Q

+ve Tinels foot

A

Radiating P in foot + toes due to aggravation of tibial N (heel)

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16
Q

What does Homans sign test

A

Thrombosis
Strain
Achilles rupture

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17
Q

Homans technqiue

A

Pt supine with leg straight
Raise leg to 10 deg
Forcefully dorsiflex foot + squeeze calf with other hand

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18
Q

+ve Homans

A

Deep P in calf- thrombosis
Local- gastrocs/soleus strain
No PF with squeeze- complete achilles rupture

19
Q

Specificity of Homans

A

41

20
Q

Sensitivity of Homans

A

35-48

21
Q

Achilles tap test procedure

A

Pt supine, seated or prone
Tap over achilles with fingers or reflex hammer
Observe for PF

22
Q

Achilles tap test interpretation

A

P or lack of PF= achilles tendonitis, achilles tendon rupture

23
Q

Buergers test

A

Pt supine
Leg straight at 45
Hold for 3 mins
Lower leg, below table, instruct Pt to sit up
Observe refilling of dorsal veins of foot

24
Q

Buergers interpretation

A

> 1-2 mins required for cyanosis (red) + refilling of dorsal veins of foot to occur = lower ex vascular compromise (PVD, atherosclerosis)

25
Q

Calcaenus squeeze test

A

Pt prone
Flex knee to 90
Squeeze in three locations
1. side
2. calcaneal tuberosity (post calcaneus)
3. medial calcaneal tubercle

Observe for P or discomfort

26
Q

Calcaneal squeeze test interpretation

A

P with
1. side- #
2. calcaneal tuberosity- retrocalcaneal bursitis, #
3. medial- plantar fasciitis

27
Q

Fibular translation test

A

Pt side lying
Examiner stabilises medial malleolus (cupping) + applies anterior + posterior force over lateral malleolus

28
Q

Fibular translation interpretation

A

P or discomfort of fibula- tear of syndesmosis ligaments

29
Q

Fib translation sens

A

82

30
Q

Fib translation spec

A

88

31
Q

Mortons procedure

A

Pt supine or seated
Examiner squeezes foot around metatarsal heads
Observe for P/discomfort

32
Q

Mortons interpretation

A

P- mortons neuroma, metatarsal Jt arthritis, # of metatarsal heads

33
Q

Mortons clinical notes

A

Usually between distal metatarsals
Between 3-4 55%, 2-3 45%

34
Q

Mortons DDx

A

Metatarsalgia P less localised with P under metatarsal heads (parasthesia not present)

Stress # P localised to metatarsal shaft- not between metatarsals (palpate directly)

Deep peroneal neuropathy- S+S between 1+2 toes

35
Q

Subtalar glide

A

Pt supine
Stabilise talus and apply a medial then lateral force to the calcaneus

36
Q

Subtalar glide interpretation

A

P or displacement calcaneus= subtalar sprain or instability

37
Q

Subtalar spec

A

75

38
Q

Subtalar sens

A

78

39
Q

Subtalar glide clinical notes

A

Should be minimal movement

40
Q

Windlass procedure

A

Pt seated
Examiner stabilises ankle in neutral + extends big toe while allowing the IP Jt to flex
Repeat with Pt standing

41
Q

Windlass interpretation

A

P or symptom reproduction- plantar fasciitis

42
Q

Windlass clinical notes

A

May extend all toes
Windlass effect is primary mechanism that lifts the medial longitudinal arch during toe off

43
Q
A

Ortho tests (15 decks)

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